That best performers get punished sums up how unhealthy the system is
Hospitals that performed best in 2012 by not going dangerously over budget are suffering the worst cuts this year.
This contrasts markedly with those that have huge deficits, including bank overdrafts, which are now getting the most generous financial injections.
It hardly seems fair. But the new method of distributing funds is all about getting every hospital to end the year with a set of balanced books.
The argument is that if heavier cuts were imposed on hospitals that are in the red, their financial state would become even more precarious.
At the same time, each hospital is expected to meet waiting-list targets, as well as keeping trolley queues at bay.
It all sounds a bit utopian and is not without risk. The best performing hospitals will be under pressure to cut more services while those with the over-run could still end up struggling.
Several hospital managers warned last year that services had already been cut to the bone.
It all comes against a background of hospitals having to treat even greater numbers of patients, many of whom have complex and costly needs.
At the same time the hospitals which are in several ministers' constituencies have been spared the worst medicine.
It is a convenient coincidence.